| NPI | 1831696780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD471429) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0028073) |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2026-06-29 |