| NPI | 1457304974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD059064L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA080135) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-09-30 |