| NPI | 1376761163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD436692) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT188780) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2019-08-26 |