| NPI | 1053353516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB06001400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MB60014) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2021-10-01 |