| NPI | 1386880813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ D06807400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R6D68) |
| 207R00000X Internal Medicine (Licence: NC 25245) | |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2009-01-06 |