| NPI | 1487636726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA08065400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 174172) |
| 202D00000X Integrative Medicine (Licence: FL 174172) | |
| 207P00000X Emergency Medicine (Licence: NY 213359) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: FL 174172) | |
| 207P00000X Emergency Medicine (Licence: AL 00024696) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2025-10-23 |