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 |