| NPI | 1356802615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: PA OS021882) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS021882) |
| 207P00000X Emergency Medicine (Licence: NJ 25MB11930800) | |
| 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NJ 25MB11930800) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-04-17 |