| NPI | 1891846234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08202500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08202500) |
| 207Q00000X Family Medicine (Licence: NJ 25MA08202500) | |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2023-05-10 |