| NPI | 1982641775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA46639) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD040706E) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2012-05-15 |