| NPI | 1619503653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MA12571300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 321573) |
| 207P00000X Emergency Medicine (Licence: CT 74965) | |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2025-10-16 |