| NPI | 1942594817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD473110) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA11137200) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2025-06-06 |