| NPI | 1427027200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C186872) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA06728600) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2023-09-20 |