| NPI | 1003900242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08311600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 70569) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2018-07-09 |