| NPI | 1861492985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 174682) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB04846900) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2014-07-23 |