| NPI | 1831754878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 316451-01) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB11287500) |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2023-11-04 |