| NPI | 1609844828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: NJ 25MB07150900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ mb71509) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2019-07-09 |