| NPI | 1386105310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME166448) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD477212) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2024-07-11 |