| NPI | 1437688652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD473520) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA11355700) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2022-07-21 |