| NPI | 1568416451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 186665-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08255400) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2019-01-03 |