NPI | 1154313724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB05965000) |
Additional Taxonomies | 208D00000X General Practice (Licence: NJ 25MB05965000) |
Enumeration Date | 2005-08-18 |
Last Update Date | 2008-05-22 |