| NPI | 1710931498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA066839) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NJ MA066839) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2018-03-26 |