| NPI | 1356365167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA05277600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA05277600) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-09-21 |