| NPI | 1417999202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB077477) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MBO77477) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2013-07-03 |