| NPI | 1356630172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10208500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 274708) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2019-07-09 |