| NPI | 1770781700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2009013988) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 251423) |
| 207P00000X Emergency Medicine (Licence: PA MD436013) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2012-02-09 |