| NPI | 1790753887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD422021) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 162826) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2009-12-07 |