| NPI | 1407430721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 4395) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT020569) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2024-09-30 |