| NPI | 1740841519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB11382000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 340710) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2025-11-20 |