| NPI | 1922669142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OT019541) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20044) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2024-07-24 |