| NPI | 1699235747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11794100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD475324) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2025-12-11 |