| NPI | 1013538545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: PA MT221391) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD480801) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2024-05-30 |