| NPI | 1730197260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 232362-01) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MA067007) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2023-12-07 |