| NPI | 1700819208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 199925-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07135200) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2015-12-30 |