| NPI | 1134356470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI 18014) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT195735) |
| Enumeration Date | 2009-06-13 |
| Last Update Date | 2016-01-10 |