| NPI | 1588689038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD037987L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 151543) |
| 207P00000X Emergency Medicine (Licence: OH 35-06-1000) | |
| 207P00000X Emergency Medicine (Licence: WV 19022) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-08 |