| NPI | 1053465112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA59422) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 144021) |
| 207R00000X Internal Medicine (Licence: FL 0070018) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2011-12-22 |