| NPI | 1649208844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA64654) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NE 24600) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2009-05-29 |