| NPI | 1760556286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD433478) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301069711) |
| 207R00000X Internal Medicine (Licence: MI 4301069711) | |
| 207R00000X Internal Medicine (Licence: PA MD433478) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2008-05-21 |