| NPI | 1558523712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA08940200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT193861) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2016-08-15 |