| NPI | 1265559785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 56427) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA063626) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-05-06 |