| NPI | 1164446761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA0429800) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA0429800) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2024-06-10 |