NPI | 1881605202 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME74534) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08130700) |
207R00000X Internal Medicine (Licence: FL ME0074534) | |
Enumeration Date | 2006-08-10 |
Last Update Date | 2013-02-25 |