| NPI | 1639122716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME86259) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA04193300) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2008-05-14 |