| NPI | 1922056548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA04362300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA04362300) |
| 207R00000X Internal Medicine (Licence: NJ NJ25MA04362300) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2010-06-28 |