| NPI | 1942436282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD334799) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 24416) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2012-06-19 |