| NPI | 1295056851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS016226) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA OS016226) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT013539) | |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2023-03-14 |