| NPI | 1013995893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA06048800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 191952) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2016-05-11 |