| NPI | 1114084423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G204638) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25ma06178500) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2026-02-03 |