| NPI | 1003200148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB10225600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB10225600) |
| 207Q00000X Family Medicine (Licence: NJ 25MB10225600) | |
| 208000000X Pediatrics (Licence: NJ 25MB10225600) | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2024-08-29 |