| NPI | 1174693873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA04055800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA40558) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2021-07-23 |