| NPI | 1548335011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.203595) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD-038349-L) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2010-06-23 |