| NPI | 1093242612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS-020206) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C7-0007250) |
| 207P00000X Emergency Medicine (Licence: PA OT017931) | |
| Enumeration Date | 2017-05-13 |
| Last Update Date | 2023-02-17 |