| NPI | 1972233138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD H0102722) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT022013) |
| Enumeration Date | 2022-06-12 |
| Last Update Date | 2025-08-25 |