| NPI | 1740772383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 19631) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS020260) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2023-12-22 |