| NPI | 1376839555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60461984) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT199355) |
| 207P00000X Emergency Medicine (Licence: PA MD449885) | |
| Enumeration Date | 2011-06-25 |
| Last Update Date | 2016-02-22 |