| NPI | 1285618199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA 016727) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25ma07735400) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2007-07-08 |