| NPI | 1063498228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD056601L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD056601L) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2008-08-05 |