| NPI | 1154582864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10716900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 264547) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2020-04-23 |