| NPI | 1114067667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA08206300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R5881) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2022-04-08 |