| NPI | 1467710756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB09637600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 3392) |
| 207P00000X Emergency Medicine (Licence: CT 64974) | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2023-11-09 |