| NPI | 1336382548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 53505) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA12127300) |
| 207R00000X Internal Medicine (Licence: CT 050667) | |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2024-04-25 |