| NPI | 1700957479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA04825700) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NJ 25MA04825700) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA04825700) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NJ MA04825700) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA04825700) | |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NJ 25MA04825700) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2017-04-18 |