| NPI | 1922687169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB12229300) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NJ 25MB12229300) | |
| 207P00000X Emergency Medicine (Licence: NY 329019-01) | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2026-06-02 |