| NPI | 1306818463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA06961300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 194612) |
| 207P00000X Emergency Medicine (Licence: PA MD056072E) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2025-01-27 |