| NPI | 1467996421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NJ 25MA11820700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 322463) |
| Enumeration Date | 2016-12-11 |
| Last Update Date | 2026-08-20 |