| NPI | 1922687169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB12229300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 329019-01) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2024-08-15 |