| NPI | 1982049789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11188300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD472530) |
| 207P00000X Emergency Medicine (Licence: NY 284060) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2024-08-13 |