| NPI | 1841829686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA13108600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101277950) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2026-07-20 |