| NPI | 1518055896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08593400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 206910) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-04-14 |