| NPI | 1427318658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 07581) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT014543) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2018-11-28 |