NPI | 1992748495 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MB03344700) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB03344700) |
Enumeration Date | 2006-06-13 |
Last Update Date | 2018-02-26 |