| NPI | 1285680371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA07055100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD046380L) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2018-07-17 |