| NPI | 1578854618 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA089190000)  | 
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NJ 25MA089190000)  | 
| Enumeration Date | 2011-04-24 | 
| Last Update Date | 2011-04-24 |