| NPI | 1609119676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD458892) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA09876900) |
| 207P00000X Emergency Medicine (Licence: NY 285361) | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2024-03-19 |