| NPI | 1023078433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101267032) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA54532) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2025-08-22 |