| NPI | 1033138169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C1-0007714) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MA79983) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2023-03-30 |