| NPI | 1598290595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS022300) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: PA OT018720) | |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2022-10-03 |