| NPI | 1235176512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 217211) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA07413300) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2025-01-15 |