| 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 |