| NPI | 1003309121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD471791) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT216196) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2025-06-07 |