| NPI | 1942647185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD20978) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT204482) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2016-08-14 |