| NPI | 1245869494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS021690) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 323385-01) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2023-08-10 |