| NPI | 1649787052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: PA MD468382) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ NA) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2019-09-26 |