NPI | 1033309562 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA02829400) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD034586L) |
Enumeration Date | 2007-07-31 |
Last Update Date | 2007-07-31 |