| NPI | 1922590868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D96689) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT215013) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2023-08-08 |