| NPI | 1124013966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A14318) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB06503500) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2022-10-14 |