| NPI | 1841850989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT218776) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME176114) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2026-05-20 |