| NPI | 1144295049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB05147400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ MB51474) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2023-12-02 |