NPI | 1114004876 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA11541600) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD455391) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2022-08-02 |