| NPI | 1609862747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA07857000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 237222) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2013-01-17 |