| NPI | 1649859497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD483805) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT222465) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2024-07-18 |