| NPI | 1073515706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NJ 25MA05762800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA05762800) |
| 207R00000X Internal Medicine (Licence: PA MD039869E) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: PA MD039869E) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2019-05-21 |