| NPI | 1801812136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NJ 25MA05250500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA05250500) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2009-06-08 |