| NPI | 1265797971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2018007371) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA09720700) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2022-10-06 |