| NPI | 1457328023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA02919800) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 029198) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2010-03-02 |