| NPI | 1396103743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11909800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 30318) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-01-31 |
| Last Update Date | 2023-11-29 |