| NPI | 1386688968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA06713300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MA67133) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2021-08-26 |