| 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 |