| NPI | 1346695442 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C204532)  | 
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA C204532)  | 
| 207R00000X Internal Medicine (Licence: NJ 25MA10811900)  | |
| Enumeration Date | 2016-04-27 | 
| Last Update Date | 2025-09-26 |