| NPI | 1801460043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD485185) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT222650) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2025-06-10 |