| NPI | 1568773711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09465900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 173072) |
| 207P00000X Emergency Medicine (Licence: NY 273055) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2022-03-02 |