| NPI | 1497266480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10567600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ Resident) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2020-05-01 |