| NPI | 1578790663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD454242) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE c1-0010402) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2015-06-19 |