| NPI | 1417981614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA04322900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD021953E) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2009-11-28 |