| NPI | 1649832379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS021925) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT019578) |
| 208600000X Surgery (Licence: PA ot019678) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT019578) | |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2024-06-06 |