| NPI | 1598842098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 235711) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25ma09595200) |
| 207Q00000X Family Medicine (Licence: NY 235711) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA09595200) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-06-28 |