| NPI | 1770559833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.141114) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD070755L) |
| 207P00000X Emergency Medicine (Licence: AL MD.29046) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2021-02-15 |