NPI | 1356574099 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08823600) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 209838-1) |
Enumeration Date | 2009-08-28 |
Last Update Date | 2023-05-18 |