| NPI | 1144630856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S1032) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10091400) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2023-04-29 |