| NPI | 1386791390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09084800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 199075) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2017-08-30 |