| NPI | 1427493311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD456579) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0011384) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2016-07-01 |