| NPI | 1326190869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA044257) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2007-01250) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2008-11-25 |