| NPI | 1780061903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10590200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 293192) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2025-01-30 |