| NPI | 1255351318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA08076) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD0425219) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2008-02-29 |