| NPI | 1740924232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD486682) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT225227) |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2024-11-08 |