| NPI | 1871938498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT015090) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.016790) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2023-09-27 |