| NPI | 1730760117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA12223100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 329669) |
| Enumeration Date | 2021-04-18 |
| Last Update Date | 2025-03-10 |