| NPI | 1679522486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 201575) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 071031) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2011-07-25 |