| NPI | 1336600378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1023177) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA11431700) |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2026-01-19 |