| NPI | 1336427517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA12007200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 263511) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2025-05-14 |