| NPI | 1700820933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA06961400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 58007) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-07-16 |