| NPI | 1598392391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD483423) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 57821) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD483423) | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2024-06-23 |