| NPI | 1164535241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 25MB05524000) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ 25MB05524000) |
| 207R00000X Internal Medicine (Licence: FL OS8714) | |
| 207Q00000X Family Medicine (Licence: NJ 25MB05524000) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2024-01-18 |