| NPI | 1013936400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB08454100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS-007148-L) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2012-08-14 |