| NPI | 1326240573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA 60204352) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD439959) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2011-07-07 |