| NPI | 1710415476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD476841) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 60117) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2022-06-22 |