| NPI | 1184091779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10254200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD461809) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2018-07-17 |