| NPI | 1952806127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO219476) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS021459) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-08-15 |