| NPI | 1851491922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA03585200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA03585200) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2024-03-30 |