| NPI | 1215483532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB10966800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS019608) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2024-07-15 |