| NPI | 1659996270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1018851) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT020176) |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2024-06-05 |