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 |