| NPI | 1396854519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2007-00427) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD427057) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-05-13 |