| NPI | 1033152277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB07097200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MB70972) |
| 207P00000X Emergency Medicine (Licence: NY 284860) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-07-24 |