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 |