| NPI | 1093020513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB09916400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 266913) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2024-02-01 |