| NPI | 1831414440 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA08954900)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08954900)  | 
| Enumeration Date | 2010-04-07 | 
| Last Update Date | 2015-05-06 |