| NPI | 1356964001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS021827) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT020063) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2025-11-25 |