NPI | 1780622944 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08109000) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 212340-1) |
Enumeration Date | 2006-06-02 |
Last Update Date | 2020-06-15 |