| NPI | 1215127907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.204730) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT190159) |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2011-11-16 |