| NPI | 1003278219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11882900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 302404) |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2026-04-21 |