| NPI | 1356432678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NJ MA41628) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA41628) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-02-06 |