| NPI | 1659993905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 323642) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB11790100) |
| Enumeration Date | 2020-05-09 |
| Last Update Date | 2024-12-10 |