| NPI | 1982830097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09092600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT195608) |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2020-08-26 |