| NPI | 1417440348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD472274) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT216178) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2021-08-11 |