| NPI | 1114926375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.092137) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA06628800) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2022-04-19 |