| NPI | 1326605049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS021583) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT019041) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2023-05-17 |