| NPI | 1720267081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08457400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 246452) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2016-08-03 |