| NPI | 1588308548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT021486) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS023521) |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2024-04-23 |