| NPI | 1306410006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD H0100392) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS023049) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2026-04-09 |