| NPI | 1801063714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PA MD478812) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA0929600) |
| 207Q00000X Family Medicine (Licence: PA md478812) | |
| 207R00000X Internal Medicine (Licence: NM MD2011-0549) | |
| 207Q00000X Family Medicine (Licence: NM MD2011-0549) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NJ 25MA09296000) | |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2024-01-15 |