| NPI | 1306803549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA04547000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD0393982) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NJ 25MA04547000) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2014-04-11 |