| NPI | 1295779098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 27236) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 054814) |
| 207P00000X Emergency Medicine (Licence: PA MD428046) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2013-03-14 |