NPI | 1104162767 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NJ 25MA09309800) |
Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA09309800) |
Enumeration Date | 2012-12-28 |
Last Update Date | 2024-05-02 |