| NPI | 1306023122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB09046600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS014003) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2013-08-13 |