| NPI | 1437207503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 138140) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA05495900) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2008-02-14 |