| NPI | 1124402078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10699800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 293293) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2023-09-22 |