NPI | 1679655930 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA60526) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ MA60526) |
Enumeration Date | 2006-10-19 |
Last Update Date | 2016-06-21 |