| NPI | 1194915512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB08772000) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS015250) |
| 207Q00000X Family Medicine (Licence: NY 264845-1) | |
| 207Q00000X Family Medicine (Licence: CT 50927) | |
| 207RH0005X Internal Medicine, Hypertension Specialist (Licence: NJ 25MB08772000) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2016-10-14 |