| NPI | 1720349723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB10011800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB10011800) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2020-02-10 |