| NPI | 1396322459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA13267600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0026851) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2026-09-04 |