| NPI | 1861996340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB10889200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A18679) |
| 207P00000X Emergency Medicine (Licence: MI 5101027279) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-06-09 |