| NPI | 1144532144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD447620) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA mt1978879) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2013-12-19 |