| NPI | 1629202486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09697600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD444287) |
| 207P00000X Emergency Medicine (Licence: MD D0076110) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2021-09-15 |