| NPI | 1487348181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT228852) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT228852) |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2024-07-11 |