| NPI | 1497795413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10939700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D55942) |
| 207R00000X Internal Medicine (Licence: MD D0055942) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-06-10 |