| NPI | 1093150880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB10027100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 18619) |
| 207P00000X Emergency Medicine (Licence: NY 287230) | |
| 207P00000X Emergency Medicine (Licence: OH 34.013062) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2018-03-17 |