| NPI | 1396242624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB11508300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS16572) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2024-06-20 |