| NPI | 1942208046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 14054) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB03567400) |
| 207R00000X Internal Medicine (Licence: NH LT-2676) | |
| 207R00000X Internal Medicine (Licence: NH T-0332) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2013-02-25 |