| NPI | 1740298710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PR 15884) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08172800) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2010-04-09 |