| NPI | 1669434346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD443060) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 052850) |
| 207P00000X Emergency Medicine (Licence: NJ 25MA07952900) | |
| 207P00000X Emergency Medicine (Licence: NY 258673-1) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2016-01-15 |