| NPI | 1649257585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C10005205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD417207) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2008-02-28 |