| NPI | 1063736924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09279400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD450681) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2019-07-08 |