| NPI | 1487617726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS004453L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB05973700) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2011-09-22 |