| NPI | 1134549330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB11468500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS021463) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: NJ 25MB11468500) | |
| Enumeration Date | 2014-04-26 |
| Last Update Date | 2025-04-21 |