| NPI | 1497749139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA05935100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA05935100) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2010-08-30 |