| NPI | 1992799522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA05991800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD034786E) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2014-05-01 |