| NPI | 1316912967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB05572300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB05572300) |
| 207R00000X Internal Medicine (Licence: PA OS006280L) | |
| 208000000X Pediatrics (Licence: NJ 25MB05572300) | |
| 208000000X Pediatrics (Licence: PA OS006280L) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2023-06-09 |