| NPI | 1427349349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD472861) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101252845) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2021-06-23 |