| NPI | 1558387480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09445900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 243353) |
| 207P00000X Emergency Medicine (Licence: DE C10007867) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-07-23 |