| NPI | 1831619220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA11605100) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NJ 25MA11605100) |
| 207R00000X Internal Medicine (Licence: NJ 25MA11605100) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2023-06-09 |