| NPI | 1518192004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD443713) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD443713) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2012-10-15 |