| NPI | 1366023533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 80462) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT222257) |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2025-03-27 |