| NPI | 1841459732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA10125100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10125100) |
| 207P00000X Emergency Medicine (Licence: NY 281756) | |
| 207P00000X Emergency Medicine (Licence: NH 17730) | |
| 207P00000X Emergency Medicine (Licence: CA A127659) | |
| 208D00000X General Practice (Licence: NJ 25MA10125100) | |
| 208D00000X General Practice (Licence: NY 281756-01) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2025-08-05 |