| NPI | 1528057866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA68406) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA06840600) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2018-02-14 |