| NPI | 1639164635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09923400) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NJ 25MA09923400) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2016-12-09 |