| NPI | 1083028666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MA10820100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT207440) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2020-07-15 |