| NPI | 1669490561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB08065000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS017050) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-05-11 |