| NPI | 1780985267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09390800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 267161) |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2017-04-27 |