| NPI | 1346986320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT226181) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101281042) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2024-01-18 |