| NPI | 1992730014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD030867E) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 28421) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2019-02-26 |