| NPI | 1992921811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA06108000) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NJ 25MA06108000) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2016-09-13 |