| NPI | 1992933154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A125049) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA09919200) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2023-05-22 |