| NPI | 1104875814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ MA060236) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ MA06023600) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2022-01-28 |