| NPI | 1780761700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10743600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 182483) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-01-23 |