| NPI | 1851363964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA03915300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 114319-1) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2014-06-03 |