| NPI | 1801208269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10564400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 60227) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2019-08-30 |