| NPI | 1235235524 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA60196)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD-031833-E)  | 
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ MA60196)  | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD-031833-E)  | |
| Enumeration Date | 2006-09-15 | 
| Last Update Date | 2016-04-25 |