| NPI | 1023205218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2011-00610) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NC 2011-00610) |
| 207R00000X Internal Medicine (Licence: NJ 25MA08797800) | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2018-05-15 |