| NPI | 1679990840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09862300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01078440A) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2020-09-14 |