| NPI | 1528314580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB09432600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 11111111) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2019-10-23 |