| NPI | 1467614693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS015845) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012416) |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2014-06-13 |