| NPI | 1396131603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB12507500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS019728) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2025-02-18 |