| NPI | 1164950531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD477700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA FW1144776) |
| 207P00000X Emergency Medicine (Licence: PA MT217413) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2023-06-19 |