| NPI | 1497714083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA5672000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD063380L) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2021-04-19 |