| NPI | 1679781942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 246790) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 048707) |
| 207P00000X Emergency Medicine (Licence: NJ 25MB11616300) | |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2024-10-13 |