| NPI | 1063973485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD485629) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 317186) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-04-01 |