| NPI | 1477136927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 70495) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT222351) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2025-04-24 |