| NPI | 1144450107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AK 7491) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD443577) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2014-08-07 |