| NPI | 1730700931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS022642) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT019950) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2024-07-11 |