| NPI | 1144808973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB12170100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 328525) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2025-02-12 |