| NPI | 1104897388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA07410900) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: NJ 25MA07410900) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2026-06-01 |