| NPI | 1649652496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB10529200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 288376) |
| Enumeration Date | 2015-06-28 |
| Last Update Date | 2019-07-22 |