| NPI | 1750573598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C1-0025795) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT186466) |
| 207P00000X Emergency Medicine (Licence: PA MD434197) | |
| 207P00000X Emergency Medicine (Licence: MD D0083931) | |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2023-02-01 |