| NPI | 1619544806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA12871000) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT021010) |
| 207P00000X Emergency Medicine (Licence: PA OT021010) | |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2025-09-16 |