| NPI | 1629495189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2019-00954) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10075000) |
| Enumeration Date | 2014-03-23 |
| Last Update Date | 2021-11-18 |