| NPI | 1902953268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25ma06928600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 208898) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2009-09-17 |