| NPI | 1851379473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA075106) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C10007347) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2016-04-25 |