| NPI | 1437786712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C1-0025914) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD480703) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-07-23 |