| NPI | 1568464311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA06550800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA06550800) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2025-03-06 |