| NPI | 1497894091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB06266700) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MB06266700) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-09-06 |