| NPI | 1003471624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT217535) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD476364) |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2022-03-29 |