| NPI | 1275776205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N9131) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25IA12678300) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2026-06-15 |