| NPI | 1740465087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A105512) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08420900) |
| 207P00000X Emergency Medicine (Licence: MD D0067954) | |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2015-07-23 |