| 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 |