| NPI | 1346301207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS004037L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB04019700) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-07-06 |