| NPI | 1588631931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD056882L) |
| Additional Taxonomies | 202K00000X (Licence: PA MD056882L) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2009-02-25 |