| NPI | 1235660390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 81217-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10735000) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-05-26 |