| NPI | 1669662219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD437732) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT190099) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2012-02-23 |