| NPI | 1043436348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08381300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 243355) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2022-07-21 |