| NPI | 1245854447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD481070) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT221212) |
| 207P00000X Emergency Medicine (Licence: PA FD2560969) | |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2023-10-13 |