| NPI | 1124266507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09557500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD439473) |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2019-05-15 |