| NPI | 1659316289 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA08193600)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25ma08193600)  | 
| Enumeration Date | 2006-06-18 | 
| Last Update Date | 2023-04-25 |