| NPI | 1821581075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD472706) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0024754) |
| 207P00000X Emergency Medicine (Licence: MD D0094416) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2022-07-06 |