| NPI | 1003485426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0103517) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT224164) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-09-15 |