| NPI | 1073528808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2009-01621) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA06555400) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2023-01-23 |