| NPI | 1679967525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11300000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 300108) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2023-06-09 |