| NPI | 1669892618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 80333) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10115600) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2018-07-31 |