| NPI | 1043638638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10520800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 291566) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2019-04-22 |