| NPI | 1598388167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD487093) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351046735) |
| 207Q00000X Family Medicine (Licence: IN 01089859A) | |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2024-12-09 |