| NPI | 1285740787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA07707800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 273313) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2019-07-18 |