| NPI | 1841829801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD485803) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX U4567) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2025-06-22 |