| NPI | 1093979353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA08771500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT194023) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2014-11-24 |