| NPI | 1831484344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD H78035) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT014128) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2014-06-20 |