| NPI | 1417156514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08265400) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA08265400) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2022-04-01 |