| NPI | 1336593649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA11035200) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NJ 25MA11035200) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2024-06-27 |