| NPI | 1508063033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB07832100) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB07832100) |
| 207P00000X Emergency Medicine (Licence: PA OS013240) | |
| 207R00000X Internal Medicine (Licence: PA OS013240) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2023-10-06 |