| NPI | 1093392375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 331119) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA12299200) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-08-12 |