NPI | 1396742342 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME139910) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA05673800) |
Enumeration Date | 2005-07-06 |
Last Update Date | 2025-07-18 |