| NPI | 1083792410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB07830000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 235375) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2022-12-15 |