| NPI | 1164730164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11463200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 269132) |
| 207R00000X Internal Medicine (Licence: NY 269132) | |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2025-04-07 |