| NPI | 1316568199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD480863) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT220101) |
| Enumeration Date | 2020-05-03 |
| Last Update Date | 2024-06-04 |