| NPI | 1205098563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 271438-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012480) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2018-06-03 |