| NPI | 1750137410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT023276) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA OS025304) |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2026-09-08 |