| NPI | 1477518298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ ma63465) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: NJ ma63465) |
| 3416L0300X Ambulance, Land Transport (Licence: PA MD055693l) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2023-04-10 |