| NPI | 1720433758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 83731) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB10447800) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2019-08-13 |