| NPI | 1790170405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11242800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 297582-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-12-13 |