| NPI | 1942242748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA05606200) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA05606200) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2021-04-29 |