| NPI | 1104023852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB08492600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C2-0024012) |
| 207P00000X Emergency Medicine (Licence: PA OS019701) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2024-10-15 |