| NPI | 1932605524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 70026) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD472758) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2022-05-23 |