NPI | 1194917963 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08448500) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 244102) |
Enumeration Date | 2007-08-15 |
Last Update Date | 2013-07-31 |