| NPI | 1245541689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2013-02273) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB10912400) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2021-07-30 |