| NPI | 1952448797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MB31922) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 247228-1) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2013-04-12 |