| NPI | 1538336789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME108993) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD433105) |
| 207P00000X Emergency Medicine (Licence: TN MD44956) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD433105) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2011-08-17 |