| NPI | 1922050442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: NY 235844) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08037800) |
| 207P00000X Emergency Medicine (Licence: NY 235844) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2019-08-21 |