| NPI | 1639520745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10538200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT210755) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2019-05-30 |