| NPI | 1811928286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB07453100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 306934) |
| 207P00000X Emergency Medicine (Licence: PA OS012430) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2025-12-04 |