| NPI | 1225582117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 333612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA11763100) |
| 207R00000X Internal Medicine (Licence: AR E-19183) | |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2026-04-09 |