| NPI | 1851829113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 85427) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10788600) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2025-04-01 |