| NPI | 1427097211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08292000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 47162) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-02-10 |