| NPI | 1669429346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA06837500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 1457131) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2014-12-08 |