| NPI | 1588289490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB11949900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS023056) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2026-05-21 |