| NPI | 1356722250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A20485) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB10642800) |
| 207P00000X Emergency Medicine (Licence: NY 298010) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2024-08-05 |