| NPI | 1942289954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD061834L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C10005072) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2016-06-10 |