| NPI | 1699973776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ unknown) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ unknown) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2019-11-18 |