| NPI | 1356501167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 252189) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD433614) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2009-07-01 |