| NPI | 1285296244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT019553) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS023105) |
| 207P00000X Emergency Medicine (Licence: TX T5445) | |
| Enumeration Date | 2019-06-30 |
| Last Update Date | 2023-08-25 |