| NPI | 1770571986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA04590600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA04827900) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2013-06-25 |