| NPI | 1215346812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA A174003) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA10221000) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NJ 25MA10221000) | |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2021-11-01 |