| NPI | 1336194596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB05928100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C2-0013340) |
| 207P00000X Emergency Medicine (Licence: PA OS 008170) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2025-01-22 |