| NPI | 1013128909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD440035) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME107242) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2012-09-11 |