| NPI | 1063677029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09266200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301093035) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2023-06-09 |