| NPI | 1164466777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 229982-0) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA07242600) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2022-07-13 |