| NPI | 1831536440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT 203941) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA09815400) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2016-07-01 |