| NPI | 1235159658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA0617190) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25ma06171900) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-11-28 |