| NPI | 1578765962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD432204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08013200) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: PA MD432204) | |
| 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: NJ 25MA08013200) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2019-10-17 |