| NPI | 1821091653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA07304700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME79508) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2022-06-15 |