| NPI | 1275682247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 66530) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB07490900) |
| 207Q00000X Family Medicine (Licence: NJ 25MB07490900) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2018-03-17 |