| NPI | 1922002765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: NJ MB63702) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ MB63702) |
| 207QA0000X Family Medicine Adolescent Medicine (Licence: NJ MB63702) | |
| 207QG0300X Family Medicine Geriatric Medicine (Licence: NJ MB63702) | |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NJ MB63702) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2020-08-27 |