| NPI | 1215124813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD437990) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT190954) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2010-02-16 |