| NPI | 1245423698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA08888700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT191741) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2024-08-06 |