| NPI | 1003266792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD470300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 64771) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2022-01-13 |