| NPI | 1003090275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09608800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 253888) |
| 207R00000X Internal Medicine (Licence: MD D0075345) | |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2018-03-23 |