| NPI | 1639378102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NJ 25MB08773200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB08773200) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2014-01-31 |