| NPI | 1649245648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD029452E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD029452E) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2014-08-18 |