| NPI | 1154732774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS017739) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB09618300) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2022-01-26 |