| NPI | 1871829515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS014562) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 2210) |
| Enumeration Date | 2009-11-01 |
| Last Update Date | 2013-07-19 |