| NPI | 1780904094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NJ 25MA08756500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD440219) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2013-07-19 |