| NPI | 1063492965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA04458000) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NJ MA44580) |
| 207RP1001X Internal Medicine Pulmonary Disease (Licence: NJ MA44580) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2015-03-18 |