| NPI | 1770544041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS017957) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 3942) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2023-02-06 |