| NPI | 1649536608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS13924) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB09061100) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2018-12-14 |