| NPI | 1194353862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101285713) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA11868900) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-08-14 |