NPI | 1467996421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11820700) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 322463) |
Enumeration Date | 2016-12-11 |
Last Update Date | 2025-06-04 |