| NPI | 1649377425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD030478E) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 9384) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-02-19 |