| NPI | 1144319682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD072017L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA76041) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-02-28 |