| NPI | 1073805479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 270609) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10368700) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2020-11-11 |