| NPI | 1487636726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA08065400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00024696) |
| 207P00000X Emergency Medicine (Licence: NY 213359) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2024-01-22 |