| NPI | 1851304364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 17641) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD072727L) |
| 207R00000X Internal Medicine (Licence: WV 17641) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2022-02-18 |