| NPI | 1699902296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09366300) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA09366300) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2018-06-01 |