| NPI | 1497953095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD459866) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 046240) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-05-15 |