| NPI | 1326508391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 321590) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB11883100) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-12-26 |