| NPI | 1427216662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: PA OT011847) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT011847) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2008-05-23 |