| NPI | 1386004828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A170736) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA11983300) |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2024-10-02 |