| NPI | 1821259573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS016128) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 2413) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2012-07-13 |