| NPI | 1255956587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 31002) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT019856) |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2024-06-12 |