| NPI | 1417950767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD061900L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07546700) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2026-02-10 |