| NPI | 1205853751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C1-0001785) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD020780E) |
| 207P00000X Emergency Medicine (Licence: MD D29910) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-04-07 |