| NPI | 1518521384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD474967) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT217258) |
| Enumeration Date | 2019-04-27 |
| Last Update Date | 2025-06-05 |