| NPI | 1700463502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB12174300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT020846) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2024-08-28 |