| NPI | 1215965942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA06760200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD069458L) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2016-04-25 |