| NPI | 1043466022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08891600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 049163) |
| 207R00000X Internal Medicine (Licence: PA MT194021) | |
| 207R00000X Internal Medicine (Licence: ME MD21760) | |
| 207R00000X Internal Medicine (Licence: NY 241725) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2024-06-11 |