| NPI | 1659437549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD020306-E) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA03525700) |
| 207R00000X Internal Medicine (Licence: NJ 25MA03525700) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2017-03-29 |