| NPI | 1376706416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09225800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA mt194014) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2016-04-19 |