| NPI | 1366700122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 266070) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB10056800) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2017-06-21 |