| NPI | 1063602753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD435213) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT188060) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD435213) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NJ MD435213) | |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2014-05-20 |