| NPI | 1790717890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09225500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2006-0076) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-08-12 |