| NPI | 1689248460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0099892) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT222965) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2024-12-30 |