| NPI | 1598405060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA12669300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 33498801) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2025-09-02 |