| NPI | 1770840209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB10391200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 278883) |
| Enumeration Date | 2012-04-22 |
| Last Update Date | 2018-08-29 |