| NPI | 1679960108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD464176) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT209768) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2018-09-18 |