| NPI | 1093956054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 258976) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25ma08815400) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2022-09-26 |