| NPI | 1710145982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 261839) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012421) |
| Enumeration Date | 2008-05-24 |
| Last Update Date | 2011-07-19 |