| NPI | 1568497824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 221446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07304300) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2013-12-03 |