| NPI | 1811912769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD421356) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 61761) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-07-21 |