| NPI | 1922115435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA72808) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 211791) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2024-06-24 |