| NPI | 1760011027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS021585) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: PA OS021585) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2024-08-20 |