| NPI | 1437136314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 2714) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT013516) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2015-12-09 |