| NPI | 1063610715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N7597) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08634000) |
| Enumeration Date | 2007-07-04 |
| Last Update Date | 2023-10-31 |