| NPI | 1124523055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11824900) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NJ 25MA11824900) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2025-09-15 |