| NPI | 1639112352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MA71690) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07169000) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2022-04-29 |