| NPI | 1124769245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS024755) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 327991) |
| 207P00000X Emergency Medicine (Licence: PA OT021580) | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2025-04-09 |