| NPI | 1134757396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A183889) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA11528900) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-07-29 |