NPI | 1053812370 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA11587400) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY P08129) |
Enumeration Date | 2018-02-22 |
Last Update Date | 2024-05-24 |