| NPI | 1093940249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA08835000) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NY 252574) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: CA A104548) | |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: NJ 25MA08835000) | |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2022-07-21 |