| NPI | 1639110836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 247379-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08063900) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2012-04-16 |