| NPI | 1013112069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08476800) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NJ 25MA08476800) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2022-07-21 |