| NPI | 1922037258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 44927) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07800000) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2020-10-13 |