| NPI | 1073059911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11137100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 82076) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2023-01-17 |