| NPI | 1750320560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD469591) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35062004) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-02-06 |