| NPI | 1447780184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS021589) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT017544) |
| 207P00000X Emergency Medicine (Licence: NJ 25MB11016200) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2024-03-27 |