| NPI | 1518127760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09150800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 248941) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2023-07-06 |