| NPI | 1821286006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10082600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 207183) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2018-01-17 |