| NPI | 1457920993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD490860) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT224223) |
| Enumeration Date | 2021-06-20 |
| Last Update Date | 2025-07-16 |