| NPI | 1245215664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NJ 25MA02961200) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA29612) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2016-12-16 |