| NPI | 1427674068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB11835700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS023341) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2025-10-08 |