| NPI | 1568732527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09584400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 274987) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2022-07-21 |