| NPI | 1538183843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ 25MA03080500) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 25MA03080500) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NJ 25MA03080500) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA03080500) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2010-10-20 |