| NPI | 1558504258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 69876) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB09297100) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2023-09-20 |