| NPI | 1316400807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101278192) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA11378900) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2023-08-01 |