| NPI | 1144802042 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1018566) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 1018566) | 
| 207P00000X Emergency Medicine (Licence: NJ 25MB11995200) | |
| Enumeration Date | 2021-04-21 | 
| Last Update Date | 2025-09-09 |