| NPI | 1366733479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD463728) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 27093) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2019-09-09 |