| NPI | 1083005151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA02974800) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA02974800) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-11 |