| NPI | 1336674498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA OS019882) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS019882) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT017725) | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2024-03-13 |