| NPI | 1528246840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08365300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 103041) |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2015-07-09 |