NPI | 1730506007 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA12024800) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R3084) |
Enumeration Date | 2014-03-25 |
Last Update Date | 2024-08-30 |