| NPI | 1104999390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA08154600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD456868) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2024-02-05 |