| NPI | 1811182801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 293890) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA12118200) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2026-02-24 |