| NPI | 1043232788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA0693250) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 205617) |
| 207P00000X Emergency Medicine (Licence: NJ MA69325) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2008-04-10 |