| NPI | 1003049255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 257915) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 2381300) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2011-02-28 |