| NPI | 1154536738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS019674) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MB08239800) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-11-02 |