| NPI | 1275844391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD450410) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA mt198205) |
| 207P00000X Emergency Medicine (Licence: OR MD175720) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2018-02-07 |