| NPI | 1912240029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 278948) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10655100) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2024-05-15 |