| NPI | 1144562687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB11098900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58.005190) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2021-09-24 |