| NPI | 1962820852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD464141) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0029836) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2026-08-06 |