NPI | 1619935160 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA06529400) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA06529400) |
Enumeration Date | 2006-05-03 |
Last Update Date | 2019-04-04 |