| NPI | 1871938498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT015090) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS017638) |
| 207P00000X Emergency Medicine (Licence: OH 34.016790) | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2026-03-10 |