| NPI | 1407813835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MB31738) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 124458) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2012-01-05 |