| NPI | 1386907731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 17066) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT201448) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2015-06-15 |