| NPI | 1396811501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 207548) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MA67648) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-01-31 |