| NPI | 1982652038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA07919500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 236025) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-10-14 |