| NPI | 1710251368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A133245) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA09058500) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2014-12-08 |