| NPI | 1265482822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NJ 25MA07696000) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD019466E) |
| 207P00000X Emergency Medicine (Licence: PA MD019466E) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2012-06-29 |