| NPI | 1740271998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA05479500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA05479500) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2013-05-16 |