| NPI | 1902226061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10634700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 281997) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2025-04-23 |