| NPI | 1699776179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA06009600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD452841) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2023-06-09 |