| NPI | 1689253601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB12201300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS023892) |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2025-08-20 |