| NPI | 1174866818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 55001) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10476400) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2020-12-09 |