| NPI | 1144588435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11536900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 74040) |
| 207P00000X Emergency Medicine (Licence: PA MT201076) | |
| 207P00000X Emergency Medicine (Licence: PA MD477256) | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2024-01-05 |