| NPI | 1285923532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD4544901) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101256286) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2026-03-02 |