| NPI | 1285804633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 49722) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB08343400) |
| Enumeration Date | 2008-03-01 |
| Last Update Date | 2021-05-13 |