| NPI | 1386692135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA02473400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA0247346) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-02-22 |