| NPI | 1093973109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA08628800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 60-239036) |
| 207PS0010X Emergency Medicine, Sports Medicine (Licence: PA MD434444) | |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2016-12-02 |