| NPI | 1174870604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MA10093500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD454906) |
| 207P00000X Emergency Medicine (Licence: PA MT202234) | |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2019-07-16 |