| NPI | 1013983998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08332100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036116200) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2011-09-20 |