| NPI | 1215291034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11122600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301101192) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2023-08-10 |