| NPI | 1588754881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA65089) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD057271L) |
| Enumeration Date | 2006-10-15 |
| Last Update Date | 2014-06-30 |