NPI | 1235550195 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MA09852300) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD453936) |
Enumeration Date | 2013-12-19 |
Last Update Date | 2019-07-17 |