| NPI | 1366405607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 82324) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB06920900) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2021-09-07 |