| NPI | 1780030486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10388800) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: NJ 25MA10388800) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2024-09-06 |