| 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 |