| NPI | 1710245667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09663900) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NJ 25MA09663900) |
| Enumeration Date | 2012-04-29 |
| Last Update Date | 2016-09-21 |