| NPI | 1497965974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 49093) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD437151) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-09-13 |