| NPI | 1356380877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD48800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD072324L) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-09-08 |