| NPI | 1033495015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09702300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 269520) |
| Enumeration Date | 2011-10-22 |
| Last Update Date | 2015-12-16 |