| NPI | 1023045028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS009794L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MB54553) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2018-12-03 |