| NPI | 1275599201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 14966) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD043663E) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2012-11-20 |