| NPI | 1093896417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10150500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ ma60971) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2019-04-25 |