| NPI | 1437240553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA60420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25ma06042000) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-02-06 |