| NPI | 1184253817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB12627900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS022697) |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2025-09-02 |