| NPI | 1083633820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 203523-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MAO65093) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-05-05 |