| NPI | 1194133710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10820400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 52049) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2024-11-21 |