| NPI | 1760428494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA06585000) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA06585000) |
| 207R00000X Internal Medicine (Licence: PA md041344l) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2018-01-17 |