| NPI | 1164424982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N5525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07840900) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2022-12-29 |