| NPI | 1265876874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10298900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 288454) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2018-07-16 |