| NPI | 1306263819 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MB12153000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 77459) |
| 207R00000X Internal Medicine (Licence: AL DO.2942) | |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2024-07-19 |