| NPI | 1992991202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 32263) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD442815) |
| 207P00000X Emergency Medicine (Licence: AZ 45103) | |
| 208600000X Surgery (Licence: PA MT191800) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2021-08-18 |