| NPI | 1396772281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA06803300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD043011L) |
| 207R00000X Internal Medicine (Licence: NJ MA68033) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2020-06-22 |