| NPI | 1346800570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS022910) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT019431) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA OT019431) | |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2023-06-23 |