| NPI | 1255505350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09236400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD441922) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2023-10-05 |