| NPI | 1285680371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA07055100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD046380L) |
| 207Q00000X Family Medicine (Licence: PA MD046380L) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD046380L) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2024-07-10 |