| NPI | 1114157393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA12384000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT195708) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2024-10-02 |