| NPI | 1952961732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-17330) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT218930) |
| 207P00000X Emergency Medicine (Licence: UT 13034934-1205) | |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2023-07-28 |