| NPI | 1659397610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA7608000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD422198) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2013-01-17 |