| NPI | 1851330609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD033171E) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD033171E) |
| 208D00000X General Practice (Licence: PA MD033171E) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-05-16 |