| NPI | 1972559870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD428508) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA06693800) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2012-05-09 |