| NPI | 1588835722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD443782) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 247879) |
| Enumeration Date | 2008-03-16 |
| Last Update Date | 2025-07-03 |