| NPI | 1922091370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB03506400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ AW8163812) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2024-12-03 |