| NPI | 1790753523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ MA45011) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA45011) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2018-12-21 |