| NPI | 1255364766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA12111300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 34143) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: MD D57455) | |
| 207P00000X Emergency Medicine (Licence: MD D57455) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2024-07-23 |