| NPI | 1134449796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD446617) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 62411-20) |
| 207P00000X Emergency Medicine (Licence: NJ 25MA09239800) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2020-10-08 |