| NPI | 1720026875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD069558L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 301056) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2021-11-03 |