| NPI | 1629013933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA05724200) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA05724200) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2021-06-04 |