| NPI | 1689642530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: PA MD069439L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD069439L) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2024-10-29 |