| NPI | 1891735015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD432882) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35084032) |
| 207P00000X Emergency Medicine (Licence: WV 21104) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2026-02-25 |