| NPI | 1932725686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 83681) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD479502) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2024-09-10 |