| NPI | 1356340657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS008015L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ MB56558) |
| 207Q00000X Family Medicine (Licence: PA OS008015L) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2024-05-22 |