| NPI | 1083689673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA08213300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 043715) |
| 207P00000X Emergency Medicine (Licence: NY 210159) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-07-13 |