| NPI | 1225237043 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL OS10698)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB08219100)  | 
| Enumeration Date | 2007-07-12 | 
| Last Update Date | 2021-03-16 |