| NPI | 1316962681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD-016462-E) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-07-2796-R) |
| 207P00000X Emergency Medicine (Licence: VA 0101235984) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-02-19 |