| NPI | 1487844189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD434852) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2009-00359) |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2016-09-27 |