| NPI | 1861548158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA08399700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD T4084) |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2024-05-08 |