| NPI | 1982963021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB09227400) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS017216) |
| 207P00000X Emergency Medicine (Licence: NY 269403) | |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2024-03-25 |