| NPI | 1568480119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 248108) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA0808300) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2017-05-08 |