| NPI | 1063826014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB10465800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 307840) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2025-10-27 |