| NPI | 1538729066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 010714) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT019423) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2024-01-22 |