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 |