| NPI | 1871520072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08668200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01057075A) |
| 207R00000X Internal Medicine (Licence: PA MD432740) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2010-10-12 |