| NPI | 1427639863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT020535) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A22652) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2024-07-17 |