| NPI | 1265530422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 208851) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA06928900) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-06-30 |