| NPI | 1245658129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10297400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD456591) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2018-05-17 |