| NPI | 1396003307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME122379) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT201108) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2015-07-10 |