| NPI | 1912985078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NJ 25MA08172700) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: RI CMD08968) |
| Enumeration Date | 2006-01-08 |
| Last Update Date | 2007-10-16 |