| NPI | 1982647038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA07803500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 232114) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2021-07-26 |