| NPI | 1972287456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS024797) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT022653) |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2025-05-08 |