| NPI | 1265000947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS022568) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT021106) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2025-06-29 |