| NPI | 1508205212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 73751) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA09840900) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2024-11-20 |