| NPI | 1780983221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD489147) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 070389) |
| 207P00000X Emergency Medicine (Licence: PA FG5872913) | |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2025-07-10 |