| NPI | 1811936503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA06388900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 043330) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-06-09 |