| NPI | 1306226139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10586200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA #MT209198) |
| Enumeration Date | 2015-06-07 |
| Last Update Date | 2019-07-01 |