| NPI | 1740923424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA12547000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 336477) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2025-05-27 |