| NPI | 1740280874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA03548300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA03548300) |
| 208000000X Pediatrics (Licence: NJ 25MA03548300) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2007-07-08 |