| NPI | 1285661306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS012489) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV WV 2166) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2013-08-01 |