| NPI | 1780098277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD470545) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2016042796) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2020-09-09 |