| NPI | 1598865990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD435710) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME37059) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2019-03-05 |