| NPI | 1225099369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 245652) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA077878) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2009-01-15 |