| NPI | 1346690450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT210894) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 277953) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2021-03-18 |