| NPI | 1538690839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD487183C) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0013561) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2025-05-28 |