| NPI | 1689879082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 493333) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD440501) |
| 207P00000X Emergency Medicine (Licence: PA MT191679) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2013-01-31 |