| NPI | 1558512855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA09010000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 11205) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2025-05-12 |