| NPI | 1083650899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA04248400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MA42484) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2019-05-21 |