| NPI | 1598709859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C10006580) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD034585E) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2025-08-18 |