| NPI | 1780209841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB11847300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1019841) |
| Enumeration Date | 2020-06-14 |
| Last Update Date | 2024-09-11 |