| NPI | 1477528842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME99649) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD042959L) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2013-07-08 |