| NPI | 1962457416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD068898L) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD068898L) |
| 208000000X Pediatrics (Licence: PA MD068898L) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2018-02-23 |