| NPI | 1609512276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT225926) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT225926) |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2025-06-16 |