| NPI | 1780612077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 146002) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB07443700) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2009-06-13 |