NPI | 1881187359 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11486400) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT216165) |
207P00000X Emergency Medicine (Licence: PA MD472962) | |
Enumeration Date | 2018-06-11 |
Last Update Date | 2022-09-08 |