| NPI | 1154308708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA06065000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA60650) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ MA60650) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: PA MD448923) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NJ MA60650) | |
| Enumeration Date | 2005-12-26 |
| Last Update Date | 2023-12-07 |