| NPI | 1194389296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD476237) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT217253) |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2022-06-13 |