NPI | 1720110547 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA03887500) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 2137731) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2010-02-22 |