| NPI | 1932429016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 266693) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C7-0004570) |
| 207P00000X Emergency Medicine (Licence: PA MT199953) | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2025-11-13 |