| NPI | 1265638787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB08949800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS014627) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT012210) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2023-06-07 |