| NPI | 1386620011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB08301800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 222921) |
| 207R00000X Internal Medicine (Licence: NH 12892) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2018-03-17 |