| NPI | 1780659144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD040603L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD18268) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2019-08-12 |