| NPI | 1881188613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD478236) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT216156) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2022-07-11 |