| NPI | 1275507030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2009-02010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB07542900) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2016-11-28 |