| NPI | 1831398957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 252656) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD431526) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2014-05-08 |