| NPI | 1689618639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB05784100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS007502L) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2013-05-09 |