| NPI | 1457381394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NM A-1549-10) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 328128) |
| 207Q00000X Family Medicine (Licence: NJ 25MB07815200) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ MB07815200) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2022-10-04 |