| NPI | 1821137225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA03791900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 37919) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2018-07-19 |