| NPI | 1043302946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA05507700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA05597700) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-09-11 |