| NPI | 1073718235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08684400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 256737) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2023-12-29 |