| NPI | 1821610981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD480854) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT219947) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2023-08-28 |