| NPI | 1821128596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD431062) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C7-0002923) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |