| NPI | 1750320040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25A04822500) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25A04822500) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2010-07-06 |