| NPI | 1568153419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS024864) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT022353) |
| Enumeration Date | 2023-05-19 |
| Last Update Date | 2025-06-06 |