| NPI | 1427353630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09659900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A115442) |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2019-07-08 |