| NPI | 1386026219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD462670) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT208606) |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2018-09-19 |