| NPI | 1659320935 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09086700)  | 
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NJ 25MA09086700)  | 
| 207P00000X Emergency Medicine (Licence: PA MD424431)  | |
| Enumeration Date | 2006-05-06 | 
| Last Update Date | 2020-12-14 |