| NPI | 1891287058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT215453) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101271870) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2021-05-18 |