| NPI | 1134358302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD448875) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 261100) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2014-03-17 |