| NPI | 1770648370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0053345) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD043477E) |
| 207P00000X Emergency Medicine (Licence: PA MD-043477-E) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2023-04-05 |