| NPI | 1093380016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA13120900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 344894) |
| 207R00000X Internal Medicine (Licence: CA A196272) | |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2026-06-16 |