| NPI | 1033360508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD439206) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MT194082) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2021-07-02 |