| NPI | 1972574713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ MB46540) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB04654000) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2024-04-12 |