| NPI | 1689024648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT212053) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 84659) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2024-05-07 |