| NPI | 1841438546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS020202) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01304300) |
| 207P00000X Emergency Medicine (Licence: PA OT017706) | |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2022-05-13 |