NPI | 1033672886 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB11885100) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C2-0024298) |
207R00000X Internal Medicine (Licence: PA OS022754) | |
Enumeration Date | 2019-04-09 |
Last Update Date | 2025-07-25 |