| NPI | 1821230004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09062300) |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: NJ 25MA09062300) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2013-05-22 |