| NPI | 1831222959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME124696) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD427273) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD427273) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2016-09-20 |