| NPI | 1720033996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA os009897l) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25mb073775) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2019-10-14 |